In 1945, the last year of World War II, syphilis prevalence in the
United States topped out at 600,000 cases. By 2000, the number of cases
had dropped more than 99%, to fewer than 6,000. The reduction in
syphilis was so dramatic that the Centers for Disease Control (CDC) had
actually launched a national plan to eliminate it. A disease that could
trace its modern history to the French occupation of Italy in 1495 might
finally be knocked out.

But just as the CDC was announcing its plan, syphilis began surging
among men who have sex with men (MSM). In San Francisco, for example,
the number of cases jumped from a barely detectable 44 in 1999 to 522 by
2002. By 2005, syphilis prevalence in the United States had jumped to
8,724 cases, more than 80% of which were in gay and bisexual men.

Today, the spread of syphilis among MSM, including those with HIV
infection, is a topic of a conversation--and concern--among primary care
providers and infectious disease specialists throughout the country. As
Khalil Ghanem, MD, PhD, of Johns Hopkins University School of Medicine
puts it, " syphilis is a huge problem, particularly among MSM with
or without HIV" (p. 29).

In this issue of RITA!, editor Mark Mascolini gives particular
attention to slowing the resurgence of syphilis among people with HIV,
including women and heterosexual males. He also looks at ways to prevent
and control chlamydia, an often "silent" infection that
significantly increases the risk of acquiring, or transmitting, HIV.

This RITA/also marks the first issue since The Center for AIDS (The
CFA), RITA!'s publisher, merged with Legacy Community Health
Services. The merger allows The CFA to expand its programs, reach a
larger number of clients, and reduce costs, while adding value to
Legacy's services. Both organizations have a long history of
serving people with HIV. The merger of the two helps to keep the
treatment and research needs of people living with the virus in focus as
the healthcare system undergoes substantial changes.